Individual
KRISTINE EILEEN TIDSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1261 S TAMIAMI TRL, SARASOTA, FL 34239-2219
(941) 366-2360
Mailing address
7931 LIMESTONE LN, SARASOTA, FL 34233-3250
(954) 646-9015
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11002779
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000000
NONE
—
Enumeration date
06/18/2019
Last updated
06/18/2019
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